Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Sports Medicine
Erschienen in: Sports Medicine 10/2003

01.08.2003 | Review Article

Elucidating the Unexplained Underperformance Syndrome in Endurance Athletes

The Interleukin-6 Hypothesis

verfasst von: Dr Paula J. Robson

Erschienen in: Sports Medicine | Ausgabe 10/2003

Einloggen, um Zugang zu erhalten

Abstract

The unexplained underperformance syndrome (UPS), previously known as the overtraining syndrome (OTS), has been defined as a persistent decrement in athletic performance capacity despite 2 weeks of relative rest. It has been proposed that UPS may be caused by excessive cytokine release during and following exercise causing a chronic inflammatory state and ‘cytokine sickness’. This article extends that hypothesis by proposing that time-dependent sensitisation could provide a model through which the aetiology of UPS may be explained. In this model, the principal abnormal factors in UPS are an increased production of and/or intolerance to interleukin (IL)-6 during exercise. Strategies to attenuate the IL-6 response to exercise that may also reduce an athlete’s susceptibility to UPS are proposed.
Literatur
1.
Budgett R, Newsholme E, Lehmann M, et al. Redefining the overtraining syndrome as the unexplained underperformance syndrome. Br J Sports Med 2000; 34(1): 67–8PubMedCrossRef
2.
Fry RW, Morton AR, Keast D. Overtraining in athletes: an update. Sports Med 1991; 12(1): 32–65PubMedCrossRef
3.
Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress? Med Sci Sports Exerc 2000; 32(2): 317–31PubMedCrossRef
4.
Kishimoto T. The biology of interleukin-6. Blood 1989; 74(1): 1–10PubMed
5.
Pedersen BK, Steensberg A, Fischer C, et al. Exercise and cytokines with particular focus on muscle-derived IL-6. Exerc Immunol Rev 2001; 7: 18–31PubMed
6.
Pedersen BK, Steensberg A, Schjerling P. Exercise and interleukin-6. Curr Opin Hematol 2001; 8(3): 137–41PubMedCrossRef
7.
Taga T, Kishimoto T. Gp 130 and the interleukin-6 family of cytokines. Annu Rev Immunol 1997; 15: 797–819PubMedCrossRef
8.
Van Wagoner NJ, Oh JW, Repovic P, et al. Interleukin-6 (IL-6) production by astrocytes: autocrine regulation by IL-6 and the soluble IL-6 receptor. J Neurosci 1999; 19(13): 5236–44PubMed
9.
Nieman DC, Nehlsen-Cannarella SL, Fagoaga OR, et al. Influence of mode and carbohydrate on the cytokine response to heavy exertion. Med Sci Sports Exerc 1998; 30(5): 671–8PubMedCrossRef
10.
Ostrowski K, Rohde T, Asp S, et al. Pro- and anti-inflammatory cytokine balance in strenuous exercise in humans. J Physiol 1999; 515 (Pt 1): 287–91PubMedCrossRef
11.
Ullum H, Haahr PM, Diamant M, et al. Bicycle exercise enhances plasma IL-6 but does not change IL-1 alpha, IL-1 beta, IL-6, or TNF-alpha pre-mRNA in BMNC. J Appl Physiol 1994; 77(1): 93–7PubMed
12.
Sondergaard SR, Ostrowski K, Ullum H, et al. Changes in plasma concentrations of interleukin-6 and interleukin-1 receptor antagonists in response to adrenaline infusion in humans. Eur J Appl Physiol 2000; 83(1): 95–8PubMedCrossRef
13.
Nehlsen-Cannarella SL, Fagoaga OR, Nieman DC, et al. Carbohydrate and the cytokine response to 2.5h of running. J Appl Physiol 1997; 82(5): 1662–7PubMed
14.
Bishop NC, Walsh NP, Haines DL, et al. Pre-exercise carbohydrate status on immune responses to prolonged cycling: II. Effect on plasma cytokine concentration. Int J Sport Nutr Exerc Metab 2001; 11(4): 503–12PubMed
15.
Steensberg A, van Hall G, Osada T, et al. Production of interleukin-6 in contracting human skeletal muscles can account for the exercise-induced increase in plasma interleukin-6. J Physiol 2000; 529 Pt 1: 237–42PubMedCrossRef
16.
Starkie RL, Angus DJ, Rolland J, et al. Effect of prolonged, submaximal exercise and carbohydrate ingestion on monocyte intracellular cytokine production in humans. J Physiol 2000; 528 (Pt 3): 647–55PubMedCrossRef
17.
Steensberg A, Toft AD, Schjerling P, et al. Plasma interleukin-6 during strenuous exercise: role of epinephrine. Am J Physiol Cell Physiol 2001; 281(3): C1001–4PubMed
18.
Jonsdottir IH, Schjerling P, Ostrowski K, et al. Muscle contractions induce interleukin-6 mRNA production in rat skeletal muscles. J Physiol 2000; 528 Pt 1: 157–63PubMedCrossRef
19.
Ostrowski K, Rohde T, Zacho M, et al. Evidence that interleukin-6 is produced in human skeletal muscle during prolonged running. J Physiol 1998; 508 (Pt 3): 949–53PubMedCrossRef
20.
Starkie RL, Arkinstall MJ, Koukoulas I, et al. Carbohydrate ingestion attenuates the increase in plasma interleukin-6, but not skeletal muscle interleukin-6 mRNA, during exercise in humans. J Physiol 2001; 533 (Pt 2): 585–91PubMedCrossRef
21.
Banks WA, Kastin AJ, Gutierrez EG. Penetration of interleukin-6 across the murine blood-brain barrier. Neurosci Lett 1994; 179(1–2): 53–6PubMedCrossRef
22.
Schobitz B, Voorhuis DA, de Kloet ER. Localization of interleukin 6 mRNA and interleukin 6 receptor mRNA in rat brain. Neurosci Lett 1992; 136(2): 189–92PubMedCrossRef
23.
Matta SG, Weatherbee J, Sharp BM. A central mechanism is involved in the secretion of ACTH in response to IL-6 in rats: comparison to and interaction with IL-1 beta. Neuroendocrinology 1992; 56(4): 516–25PubMedCrossRef
24.
Dunn AJ, Wang J, Ando T. Effects of cytokines on cerebral neurotransmission: comparison with the effects of stress. Adv Exp Med Biol 1999; 461: 117–27PubMedCrossRef
25.
Wang J, Dunn AJ. Mouse interleukin-6 stimulates the HPA axis and increases brain tryptophan and serotonin metabolism. Neurochem Int 1998; 33(2): 143–54PubMedCrossRef
26.
Chai Z, Gatti S, Toniatti C, et al. Interleukin (IL)-6 gene expression in the central nervous system is necessary for fever response to lipopolysaccharide or IL-1 beta: a study on IL-6-deficient mice. J Exp Med 1996; 183(1): 311–6PubMedCrossRef
27.
Schobitz B, Pezeshki G, Pohl T, et al. Soluble interleukin-6 (IL-6) receptor augments central effects of IL-6 in vivo. FASEB J 1995; 9(8): 659–64PubMed
28.
Maes M, Lin AH, Delmeire L, et al. Elevated serum interleukin-6 (IL-6) and IL-6 receptor concentrations in posttraumatic stress disorder following accidental man-made traumatic events. Biol Psychiatry 1999; 45(7): 833–9PubMedCrossRef
29.
Baker DG, Ekhator NN, Kasckow JW, et al. Plasma and cerebrospinal fluid interleukin-6 concentrations in posttraumatic stress disorder. Neuroimmunomodulation 2001; 9(4): 209–17PubMedCrossRef
30.
Jones SA, Horiuchi S, Topley N, et al. The soluble interleukin 6 receptor: mechanisms of production and implications in disease. FASEB J 2001; 15(1): 43–58PubMedCrossRef
31.
Oh JW, Van Wagoner NJ, Rose-John S, et al. Role of IL-6 and the soluble IL-6 receptor in inhibition of VCAM-1 gene expression. J Immunol 1998; 161(9): 4992–9PubMed
32.
Nishimoto N, Sasai M, Shima Y, et al. Improvement in Castleman’s disease by humanized anti-interleukin-6 receptor antibody therapy. Blood 2000; 95(1): 56–61PubMed
33.
Kurzrock R. The role of cytokines in cancer-related fatigue. Cancer 2001; 92 (6 Suppl.): 1684–8PubMedCrossRef
34.
Budgett R. Fatigue and underperformance in athletes: the overtraining syndrome. Br J Sports Med 1998; 32(2): 107–10PubMedCrossRef
35.
Heney D, Lewis IJ, Evans SW, et al. Interleukin-6 and its relationship to C-reactive protein and fever in children with febrile neutropenia. J Infect Dis 1992; 165(5): 886–90PubMedCrossRef
36.
Spath-Schwalbe E, Hansen K, Schmidt F, et al. Acute effects of recombinant human interleukin-6 on endocrine and central nervous sleep functions in healthy men. J Clin Endocrinol Metab 1998; 83(5): 1573–9PubMedCrossRef
37.
38.
Bell IR. White paper: neuropsychiatric aspects of sensitivity to low-level chemicals: a neural sensitization model. Toxicol Ind Health 1994; 10(4–5): 277–312PubMed
39.
40.
Derman W, Schwellnus MP, Lambert MI, et al. The ‘worn-out athlete’: a clinical approach to chronic fatigue in athletes. J Sports Sci 1997; 15(3): 341–51PubMedCrossRef
41.
Urhausen A, Kindermann W. Diagnosis of overtraining: what tools do we have? Sports Med 2002; 32(2): 95–102PubMedCrossRef
42.
Fry RW, Morton AR, Keast D. Periodisation and the prevention of overtraining. Can J Sport Sci 1992; 17(3): 241–8PubMed
43.
Maes M, Ombelet W, De Jongh R, et al. The inflammatory response following delivery is amplified in women who previously suffered from major depression, suggesting that major depression is accompanied by a sensitization of the inflammatory response system. J Affect Disord 2001; 63(1–3): 85–92PubMedCrossRef
44.
Fry RW, Grove JR, Morton AR, et al. Psychological and immunological correlates of acute overtraining. Br J Sports Med 1994; 28(4): 241–6PubMedCrossRef
45.
Post RM. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 1992; 149(8): 999–1010PubMed
46.
Oladehin A, Waters RS. Location and distribution of fos protein expression in rat hippocampus following acute moderate aerobic exercise. Exp Brain Res 2001; 137(1): 26–35PubMedCrossRef
47.
Puntschart A, Wey E, Jostarndt K, et al. Expression of fos and jun genes in human skeletal muscle after exercise. Am J Physiol 1998; 274 (1 Pt 1): C129–37PubMed
48.
Miyahara S, Komori T, Fujiwara R, et al. Effects of repeated stress on expression of interleukin-6 (IL-6) and IL- 6 receptor mRNAs in rat hypothalamus and midbrain. Life Sci 2000; 66(6): L93–8CrossRef
49.
Wijsman JA, Shivers RR. Heat stress affects blood-brain barrier permeability to horseradish peroxidase in mice. Acta Neuropathol (Berl) 1993; 86(1): 49–54CrossRef
50.
de Vries HE, Blom-Roosemalen MC, van Oosten M, et al. The influence of cytokines on the integrity of the blood-brain barrier in vitro. J Neuroimmunol 1996; 64(1): 37–43PubMedCrossRef
51.
Lustig S, Danenberg HD, Kafri Y, et al. Viral neuroinvasion and encephalitis induced by lipopolysaccharide and its mediators. J Exp Med 1992; 176(3): 707–12PubMedCrossRef
52.
Ostrowski K, Schjerling P, Pedersen BK. Physical activity and plasma interleukin-6 in humans: effect of intensity of exercise. Eur J Appl Physiol 2000; 83(6): 512–5PubMedCrossRef
53.
Ronsen O, Lea T, Bahr R, et al. Enhanced plasma IL-6 and IL-1ra responses to repeated vs single bouts of prolonged cycling in elite athletes. J Appl Physiol 2002; 92(6): 2547–53PubMed
54.
Brock-Utne JG, Gaffin SL, Wells MT, et al. Endotoxaemia in exhausted runners after a long-distance race. S Afr Med J 1988; 73(9): 533–6PubMed
55.
Jeukendrup AE, Vet-Joop K, Sturk A, et al. Relationship between gastro-intestinal complaints and endotoxaemia, cytokine release and the acute-phase reaction during and after a long-distance triathlon in highly trained men. Clin Sci (Lond) 2000; 98(1): 47–55CrossRef
56.
Penttila IA, Harris RJ, Storm P, et al. Cytokine dysregulation in the post-Q-fever fatigue syndrome. Q J Med 1998; 91(8): 549–60CrossRef
57.
Vallieres L, Rivest S. Interleukin-6 is a needed proinflammatory cytokine in the prolonged neural activity and transcriptional activation of corticotropin: releasing factor during endotoxemia. Endocrinology 1999; 140(9): 3890–903PubMedCrossRef
58.
Chung NK, Shabbir M, Lim CL. Cytokine levels in patients with previous heatstroke under heat stress. Mil Med 1999; 164(4): 306–10PubMed
59.
Hammami MM, Bouchama A, Al Sedairy S, et al. Concentrations of soluble tumor necrosis factor and interleukin-6 receptors in heatstroke and heatstress. Crit Care Med 1997; 25(8): 1314–9PubMedCrossRef
60.
Maes M, Meltzer HY, Bosmans E, et al. Increased plasma concentrations of interleukin-6, soluble interleukin-6, soluble interleukin-2 and transferrin receptor in major depression. J Affect Disord 1995; 34(4): 301–9PubMedCrossRef
61.
Sluzewska A, Rybakowski J, Bosmans E, et al. Indicators of immune activation in major depression. Psychiatry Res 1996; 64(3): 161–7PubMedCrossRef
62.
Song C, Kenis G, van Gastel A, et al. Influence of psychological stress on immune-inflammatory variables in normal humans: part II. Altered serum concentrations of natural anti-inflammatory agents and soluble membrane antigens of monocytes and T lymphocytes. Psychiatry Res 1999; 85(3): 293–303PubMedCrossRef
63.
Heller SR, Cryer PE. Reduced neuroendocrine and symptomatic responses to subsequent hypoglycemia after 1 episode of hypoglycemia in nondiabetic humans. Diabetes 1991; 40(2): 223–6PubMedCrossRef
64.
Galassetti P, Mann S, Tate D, et al. Effects of antecedent prolonged exercise on subsequent counterregulatory responses to hypoglycemia. Am J Physiol Endocrinol Metab 2001; 280(6): E908–17PubMed
65.
Davis SN, Shavers C, Mosqueda-Garcia R, et al. Effects of differing antecedent hypoglycemia on subsequent counter-regulation in normal humans. Diabetes 1997; 46(8): 1328–35PubMedCrossRef
66.
Path G, Scherbaum WA, Bornstein SR. The role of interleukin-6 in the human adrenal gland. Eur J Clin Invest 2000; 30Suppl. 3: 91–5PubMedCrossRef
67.
Tsigos C, Papanicolaou DA, Kyrou I, et al. Dose-dependent effects of recombinant human interleukin-6 on glucose regulation. J Clin Endocrinol Metab 1997; 82(12): 4167–70PubMedCrossRef
68.
Liao J, Keiser JA, Scales WE, et al. Role of epinephrine in TNF and IL-6 production from isolated perfused rat liver. Am J Physiol 1995; 268 (4 Pt 2): R896–901PubMed
69.
Ritchie DG. Interleukin 6 stimulates hepatic glucose release from prelabeled glycogen pools. Am J Physiol 1990; 258 (1 Pt 1): E57–64PubMed
70.
Wischnia B. Comeback at Comrades. Runners World 1994; 8: 76–7
71.
Hooper SL, Mackinnon LT, Howard A, et al. Markers for monitoring overtraining and recovery. Med Sci Sports Exerc 1995; 27(1): 106–12PubMed
72.
Armstrong LE, VanHeest JL. The unknown mechanism of the overtraining syndrome: clues from depression and psychoneuroimmunology. Sports Med 2002; 32(3): 185–209PubMedCrossRef
73.
Fishman D, Faulds G, Jeffery R, et al. The effect of novel polymorphisms in the interleukin-6 (IL-6) gene on IL-6 transcription and plasma IL-6 levels, and an association with systemic-onset juvenile chronic arthritis. J Clin Invest 1998; 102(7): 1369–76PubMedCrossRef
74.
Morgan WP, Costill DL, Flynn MG, et al. Mood disturbance following increased training in swimmers. Med Sci Sports Exerc 1988; 20(4): 408–14PubMedCrossRef
75.
Rushall B. A tool for measuring stress tolerance in elite athletes. J Appl Sports Psychol 1990; 2: 64
76.
Nishimoto N, Kishimoto T, Yoshizaki K. Anti-interleukin 6 receptor antibody treatment in rheumatic disease. Ann Rheum Dis 2000; 59Suppl. 1: i21–7PubMedCrossRef
Metadaten
Titel
Elucidating the Unexplained Underperformance Syndrome in Endurance Athletes
The Interleukin-6 Hypothesis
verfasst von
Dr Paula J. Robson
Publikationsdatum
01.08.2003
Verlag
Springer International Publishing
Erschienen in
Sports Medicine / Ausgabe 10/2003
Print ISSN: 0112-1642
Elektronische ISSN: 1179-2035
DOI
https://doi.org/10.2165/00007256-200333100-00004

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Ärztliche Empathie hilft gegen Rückenschmerzen

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

16.04.2024 | Spondylitis ankylosans | Nachrichten

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

15.04.2024 | Knie-TEP | Nachrichten

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger
weitere anzeigen

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise